Hüseyin AŞKAR, Cemil ERTÜRK, MEHMET AKİF ALTAY, ALİ BİLGE

Bipolar dislocation of the forearm (floating forearm)

Bipolar dislocation of the forearm (floating forearm) is an unusual injury and is therefore often overlooked. We report a 28-year-old male patient who presented at another center with a history of a fall while climbing a tree. The patients left elbow was treated with closed reduction and immobilization with a long-arm cast brace due to elbow dislocation. However, the patient was admitted with pain and swelling of the wrist to our emergency department the following day. Physical and radiological examination revealed dorsal trans-scaphoid perilunate dislocation. A dorsal incision was performed for open reduction and internal fixation to provide wide surgical exposure. Concomitant occurrence of elbow dislocation and fracture-dislocation of the perilunate is infrequent. Therefore, physicians should be aware of possible additional injuries and current recommended treatment methods.

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1. Chen WS. Concurrent perilunate dislocation in patients with elbow dislocation: case reports. J Trauma 1994;37:504-7.

2. Prasad K, Dayanandam B, Gakhar H, Attarwala U, Karras K. Concomitant elbow and perilunate dislocation: floating forearm. The Internet Journal of Orthopedic Surgery [Internet]. 2007 [cited 2011 Aug 10] Volume 8 Number 1. Available from: http://ispub.com/IJOS/8/1/10950.

3. Daoudi A, Elibrahimi A, Loudiyi WD, Elmrini A, Chakour K, Boutayeb F. Bipolar forearm dislocation or floating forearm (a case report). [Article in French] Chir Main 2009;28:53-6. [Abstract]

4. Zejjari H, Louaste J, Chkoura M, Rachid K. Bilateral floating forearm: a case report. [Article in French] Chir Main 2011;30:155-8. [Abstract]

5. Cassidy C, Ruby LK. Fractures and dislocations of the carpus. In: Browner BD, Jupiter JB, Levine AM, Trafton PG, Krettek C, editors. Skeletal trauma. Vol. 2, Chapter: 39. 4th ed. Philadelphia: W.B. Saunders Co; 2009. p. 1343-1403.

6. Herzberg G, Comtet JJ, Linscheid RL, Amadio PC, Cooney WP, Stalder J. Perilunate dislocations and fracture-dislocations: a multicenter study. J Hand Surg Am 1993;18:768-79.

7. Stanbury SJ, Elfar JC. Perilunate dislocation and perilunate fracture-dislocation. J Am Acad Orthop Surg 2011;19:554-62.

8. Garcia-Ellias M, Geissler WB. Carpal instability. In: Green DP, Hotchkiss RN, Pederson WC, Wolfe SW, editors. Greens operative hand surgery. Vol. 1, 5th ed. Philadelphia: Elsevier Churchill Livingstone; 2005. p. 535-604.

9. Linscheid RL, Dobyns JH, Beabout JW, Bryan RS. Traumatic instability of the wrist. Diagnosis, classification, and pathomechanics. J Bone Joint Surg Am 1972;54:1612-32.

10. Adkison JW, Chapman MW. Treatment of acute lunate and perilunate dislocations. Clin Orthop Relat Res 1982;164:199-207.